Sarasota, FL (WorkersCompensation.com) – The recent 20th anniversary of the 9/11 terrorist attacks serves as a reminder that there are people living with post-traumatic stress disorder. Their symptoms may affect the workplace. While it’s not the employer’s job to diagnose or treat an affected employee, being aware of certain behaviors and showing concern and support can go a long way to helping workers who may be suffering.
What is PTSD?
“PTSD is one thing that happens in response to particularly difficult events. You either experience yourself or you witness a life-threatening or integrity-threatening event,” said Les Kertay, a consulting psychologist and medical director for New York Life Insurance Company. “Electronically being exposed – all of us who saw those planes hit the towers over and over and over again – that doesn’t qualify for PTSD, despite the fact it’s a horrific scene. You have to directly experience it.”
Sexual assault victims have a fairly high incidence of PTSD. Other potential events for PTSD are combat, natural disasters and severe car accidents. But most people exposed to such tragedies do not experience PTSD.
“The most likely response to a potentially traumatic event is we get really disrupted, we get shook up. A lot of us experienced that around 9/11, for example. Then people recover. They get better. We tend to be pretty resilient,” Kertay said. “Other people may experience that disruption for longer periods of time. Some experience PTSD.”
PTSD is a series of symptoms that typically begin fairly soon after the triggering event, although symptoms may appear much later. What distinguishes PTSD from other conditions, such as acute stress disorder, is that the symptoms last longer than four weeks.
Symptoms may include reliving or re-experiencing the event; gong to extensive lengths to avoid reminders of the event; having more negative thoughts and feelings than before the event, and hyperarousal, or feeling on edge.
PTSD can be chronic with symptoms recurring. But even for those most severely impacted, PTSD can be treated.
“That’s important to remember because, unfortunately, with mental health, we tend to write people off when they have a mental health condition and think ‘this is going to be forever,’ ‘I don’t know what to do about that or how to talk to you about that so I’m not going to have those conversations,” Kertay said. “And that to me is as tragic as some of what else goes on is that there are people walking around who are wounded psychologically but also isolated because we don’t know how to respond.”
During a stint with the U.S. military in Afghanistan, Anthony Merino witnessed many pediatric casualties. The now retired Vendor Manager, Sergeant First Class in the U.S. Army reiterated one particular tragedy in which a young boy’s face was burned off, his scalp was nearly completely off and both eyes had been ruptured. While Merino and his coworkers were able to help the boy survive, that and other incidents stayed with him after he returned home.
“One day my youngest son had started walking, bumped his head on the coffee table and was crying,” Merino said. “I went outside and was crying. I couldn’t control it.”
Things got gradually worse and he began drinking heavily. He didn’t understand what was going on.
“What I found out was, in reality I didn’t want to get help because I didn’t think anything was wrong with me. I didn’t want to talk to anybody who hadn’t experienced what I had,” Merino said. “That was a big mistake.”
Merino eventually opened up to his wife and others about what he was feeling. He started talking with other soldiers in his unit and sharing his story. “I didn’t like to talk abut a lot of the stuff, but I do find it helps to just have that open dialogue,” he said.
Using techniques such as resilience and mindfulness training, Merino was better able to deal with his issues – even when he has the occasional anxiety attack. He is better able to identify and manage the symptoms.
“We all go through some things. We are not alone,” Merino said. “We tend to get in that mindset where we think we are the only one dealing with things like that. Everybody has something they’ve dealt with … that’s imprinted on them.”
Memory problems, lack of concentration, fear/anxiety, poor relationships with coworkers, unreasonable reactions to situations that trigger memories and absenteeism are among the many ways PTSD can manifest itself among employees. Though the symptoms are not unique to PTSD, they can be red flags that something is wrong.
“All of a sudden [the worker is] forgetting meetings; somebody is unusually late to work and it’s unexpected,” Kertay said. “So there’s a change in behavior.”
Behavior that represents a performance problem should be the focus of the employer when approaching the employee – not the specific medical condition.
“I’d make those points with HR teams,” said Dara Wheeler, Chief Marketing Officer for Axiom Medical. “It’s not your job to determine [if it’s PTSD]; it is your job to step in and help, support, recognize behaviors – not be the one to diagnose.
Failing to address such behavioral issues should be avoided, Wheeler advises. Instead, address them and make sure they know of any resources are available – and be empathetic. A manager can start a conversation with something like, “I see you are showing up late a lot.”
“Often there is a concern about intruding in somebody’s privacy when you start talking about a mental health thing,” Kertay said. “Really, the place to start is ‘how are you doing?’ ‘I see these things going on, how are you doing?’ That’s not a violation of somebody’s privacy. It’s expressing concern, which is appropriate.”
After addressing the performance issue, the manager can follow by asking how the person is doing, if there is something going on.
“Once we get past that point it gets harder because what you have to do then is listen to the answer and reflect back what you heard,” Kertay said. “It’s interesting. If I’m having trouble at work because I have something psychological going on I can promise you I want to talk about it. But when somebody else avoids talking about it, it’s really hard for me to bring it up and I feel more isolated. The most important thing is make the observation, ask, listen to what you get back.”